Abstract
Objective Interdisciplinary team–based models of rheumatology care, where rheumatologists and interdisciplinary healthcare professionals deliver care collaboratively, offer a promising solution to improve integrated care; however, an understanding of patients’ experiences with this approach remains limited. We explored patients’ perspectives on receiving care through an interdisciplinary team–based model.
Methods This was a qualitative study informed by qualitative description. We conducted a secondary analysis of semistructured interviews with patients receiving care through an interdisciplinary model in Ontario, Canada. The interviews explored patients’ experiences with team-based care and its perceived impact on disease management. We inductively coded interview transcripts and constructed themes using thematic analysis.
Results Among 15 participants, 47% were female, 10 (67%) had inflammatory arthritis, 3 (20%) had other inflammatory rheumatic diseases, and 2 (13%) had osteoarthritis. We identified 5 overarching themes: (1) educational empowerment, (2) unhurried thoroughness, (3) responsive care, (4) timely care, and (5) personalized care through multispecialist collaboration. Participants perceived team-based care to offer enhanced access, including prompt appointments and timely responses to phone calls, attributed to the involvement of multiple health professionals. Participants described care as comprehensive and proactive, addressing needs beyond what a rheumatologist alone could provide. Longer consultations enabled thorough assessments, education, and support across all aspects of disease management. Participants valued the integrated “one-stop shop” model, which reduced the number of external referrals and separate appointments.
Conclusion Patients valued interdisciplinary team–based rheumatology care for improving care access and delivering integrated, convenient, comprehensive care that holistically addressed their needs. These results support wider implementation.
Rheumatic and musculoskeletal diseases (RMDs) affect millions worldwide,1-3 leading to chronic pain, functional limitations, and reduced quality of life,2 and imposing a significant burden on healthcare systems.3 However, patients with RMDs face delayed diagnosis and fragmented care,3,4 resulting in inadequate disease control and reduced quality of life.3
To improve timely and patient-centered care, there is growing interest in interdisciplinary team–based models of rheumatology care. In interdisciplinary teams, healthcare professionals from multiple disciplines collaborate in the assessment and management of patients.5 Teams typically include rheumatologists and interdisciplinary healthcare professionals (IHPs), such as physiotherapists, occupational therapists, pharmacists, and/or nurses, who may take on expanded responsibilities beyond their traditional scopes of practice.5,6 Interdisciplinary care models address known access challenges by increasing service capacity through task dispersion among team members alongside rheumatologists.7-10 This shared workload can enhance care comprehensiveness7 and may lead to improved disease outcomes, patient satisfaction, and more timely access to care by leveraging diverse professional expertise.11-17
However, research on patient experiences receiving interdisciplinary team–based rheumatology care is limited.18 Most studies have focused on clinical outcomes, such as disease activity and functional ability,11,15,17,19-21 leaving gaps in understanding how patients perceive care delivered by multiple professionals that include nonphysicians carrying out tasks traditionally performed by rheumatologists. Questions remain about patient acceptance, comfort, and trust in care from expanded provider roles. Exploring patient perspectives is crucial because it reveals what matters most to patients and helps identify potential barriers to the acceptance of team-based models.16,17,22 Patient experience studies are essential for informing the successful scale-up of interdisciplinary models, offering insights that help healthcare systems design and implement team-based services that patients will embrace and benefit from.23
Our aim was to explore patient perspectives on rheumatology care delivery within an interdisciplinary team–based care model, including perceived effects on disease management.
METHODS
Study design. This qualitative study involved a secondary analysis of interviews with RMD patients collected as part of a larger study24 that sought to understand and describe the program theory of an interdisciplinary team–based model of rheumatology care.
We used a qualitative descriptive approach to understand and describe patients’ perspectives regarding team-based care in rheumatology.25,26 Qualitative description provides a thorough account of experiences, staying close to the data, and is relevant for understanding and describing patients’ concerns, thoughts, feelings, and attitudes related to healthcare experiences.25-27
The study followed the Consolidated Criteria for Reporting Qualitative Studies checklist for reporting qualitative research.26,28
Setting. Canada’s publicly funded healthcare system covers most physician services through provincial insurance. In Ontario, rheumatology care is predominantly delivered in physician-centered, independent practices.29 This study examined patient perspectives at the Centre of Arthritis Excellence (CArE) in Newmarket, Ontario,30 which is a provincial government-funded community-based rheumatology team established in 1991 (formerly The Arthritis Program). As the province’s only government-funded, community-based interdisciplinary rheumatology team, CArE provides comprehensive care through an interprofessional team offering both in-person and virtual services.
Patients are referred to CArE by their primary care providers using a standardized referral form, with IHPs triaging referrals based on diagnosis, urgency, and care needs. Initial consultations involve a collaborative assessment where an IHP working as an advanced practice practitioner completes the intake assessment, followed by a rheumatologist consultation, with both professionals working together with the patient to develop a comprehensive management plan. Subsequent visits follow a similar collaborative structure, and between visits, patient queries are addressed by the most appropriate team member.
The team, which has included rheumatologists, pharmacists, occupational therapists, physical therapists, nurses, nurse practitioners, kinesiologists, dietitians, and social workers, works collaboratively to longitudinally evaluate and comanage patients, including assessments, medication monitoring, patient education, and ongoing disease management support.
Sampling. We analyzed transcripts from semistructured interviews conducted with 15 individuals with RMDs. Patients who had attended CArE within the prior 10 years (2014-2024) were eligible to participate. We used purposive sampling to ensure variation in age, type and length of disease diagnosis, and sex, aiming to incorporate a wide range of perspectives from information-rich participants.
Data collection. Semistructured interviews were conducted by 1 researcher (ZL, a doctoral student with qualitative expertise) with no prior relationship to the participants. An interview guide (Supplementary File S1, available from the authors upon request) was developed by the research team, which included 2 individuals (CB, CH) living with RMD and included open-ended questions to explore participants’ experiences with team-based care. Questions explored participants’ journey through the healthcare system, their interactions with various healthcare providers, their experiences with different team members, the communication among healthcare team members, their perspectives on the team-based model of care delivery, and their experiences with seeking care between visits. The interview guide was pilot-tested with 2 people with lived experience (CB, CH).
Interviews were conducted via phone or video call using the videoconferencing platform Zoom. Audio recordings were transcribed verbatim by a professional transcription service and data were organized using NVivo 12 (Lumivero).
Data analysis. Data were analyzed using inductive thematic analysis. As this was a secondary analysis, 3 researchers (ZL, LK, CL) were already familiar with the dataset. Building on this foundation, a preliminary codebook was developed by GS (undergraduate student) and ZL, with feedback from LKK (rheumatologist experienced in qualitative research) and CL (health services researcher with qualitative expertise). To calibrate coding, GS independently coded 3 transcripts, followed by review by a second researcher (ZL), with discussion after each transcript to address discrepancies and refine codes. The team’s prior intimate knowledge of the data enabled efficient single coding with verification rather than requiring duplicate independent coding.
Disagreements or major framework changes were resolved with LKK and CL. Following calibration, GS coded the remaining transcripts independently.
Initial codes were developed inductively, with researchers looking for patterns and meanings within participants’ accounts relevant to our research question. Through an iterative process of review and refinement, preliminary codes were organized into potential themes. These themes were reviewed against the coded extracts and the entire dataset to ensure accuracy.27 Constant comparative analysis was used between and across interviews, with researchers acknowledging and reflecting on how their own experiences might influence the coding process.27 To ensure rigor, analytic memos and an audit trail documented decision making and emerging interpretations.31 Themes were reviewed with the analytics team, including individuals with lived experience (CB, CH)—one with and one without team-based care experience—who provided contrasting perspectives.
RESULTS
Participant characteristics. We interviewed 15 participants, median age 62 years and 7 (47%) were female. Ten (67%) had inflammatory arthritis, of whom 6 (40%) had rheumatoid arthritis, 2 had axial spondyloarthritis, and 2 had psoriatic arthritis. Three had other inflammatory rheumatic diseases (20%), and 2 (13%) had osteoarthritis. Participant characteristics are shown in Table 1.
Characteristics of study participants.
Themes. We developed 5 overarching themes that capture patients’ perspectives with rheumatology care delivered within an interdisciplinary team: educational empowerment, unhurried thoroughness, responsive care, timely care, and personalized care through multispecialist collaboration. We present our findings with illustrative quotes. Additional quotes are provided in Table 2.
Additional illustrative quotes supporting study themes.
Theme 1: Educational empowerment. Participants described how team-based care provided comprehensive education and practical support throughout their disease journey. The interdisciplinary approach offered 2 distinct but complementary forms of empowerment: enhanced understanding of their condition and its long-term implications, and practical skills training for daily management. Together, these educational components helped patients mentally prepare for and actively participate in their ongoing care.
Participants described how being supported by multiple healthcare professionals within the same clinic enabled them to receive diverse yet coordinated educational perspectives, fostering a more complete understanding of their condition and its long-term implications:
I’m, I guess, fortunate to be at CArE, it’s because the ability to have conversations with the pharmacists, the occupational therapists, the physiotherapist, because when you’re going through this, especially in the early stages, and you don’t really know what it [needs]. You don’t really know how this is going to change [your] life. And so, there’s this huge, like, an informational learning curve that you need to get up. And I think, like, being there I have to believe that that’s helped a lot, you know. That learning curve and having all those people who are kind of like an extension of the doctors themselves. (patient [P] 14)
Alongside this deeper understanding of their condition, this educational approach also involved practical skills training. This training, which was conveniently offered seamlessly within the same clinic setting, was highly valued by participants, particularly for medication administration and self-management techniques:
She [nurse practitioner] showed me how to self-inject. So she got me comfortable with how to give myself my shot every week. She got me comfortable with the medicines and the side effects and what to look for. (P5)
Beyond the comprehensive content, participants valued the personalized support and guidance that came with team-based education, which they felt was superior to what participants could access independently through other sources:
Having that additional support, rather than just being on your own, looking at websites… there could be a disadvantage sometimes to just reading things on the web. (P14)
The collaborative nature of the team-based approach, where multiple professionals provided complementary tools and guidance, facilitated patients’ sense of ownership and engagement, ultimately empowering them in their own care:
It’s that collaboration where they provide the tools and then you take it from there and it’s basically your choice…. You have to be able to take some ownership of your care, but you can’t do that if you don’t know what to pack [what tools and knowledge you need]. (P31)
The educational programming was tailored to the needs of patients with inflammatory arthritis, who require ongoing, intensive support. Educational needs of patients with noninflammatory arthritis were less directly addressed, which influenced how they engaged with available resources:
I went to The Arthritis Program for approximately a year, and then I stopped going. And the reason was that The Arthritis Program was for a certain set of autoimmune conditions, which now I fell outside of. (P5)
Theme 2: Unhurried thoroughness. Participants described a thoroughness of clinic visits within the team-based model that they did not receive in their other, more conventional, interactions within the healthcare system. Interactions with the IHPs tended to be longer than time spent with the rheumatologist, in both initial and subsequent visits. These longer visits included assessments of both their health and life circumstances and focused on ensuring that their needs were fully understood and there was a clear path forward to achieve equitable outcomes. Participants reported how the absence of perceived time pressure created space for deeper assessment and discussion that patients felt was often missing in traditional care settings:
[The visit] is still long, because you go in and you’re there for at least 45 minutes, going through everything with [the nurse]. This is detailed—you go through all your medications, [and] all your supplements, you talk about your blood work, you talk about any problems you’re having, she examines you, like physically examines you. And so it does take a while. (P2)
The absence of perceived time pressure during consultations was frequently mentioned as a distinguishing feature of the team-based care model:
The arthritis clinic is such a contrast to that where there isn’t the rushed aspect, and they take the time and there’s the full assessment. I think that’s why the arthritis clinic seems so unique is because I’m used to those [general practitioner] appointments that are so quick. (P25)
This unhurried and thorough approach created opportunities for deeper exploration of concerns that might be overlooked in briefer visits, allowing for more comprehensive patient histories, identification of connections between symptoms and life circumstances that might otherwise be missed, and development of stronger therapeutic relationships between patients and IHPs:
The team-based care is definitely an aspect to replicate and just the time that they take to understand your situation. Having that one-and-a-half-hour initial appointment… I felt like I could go through my entire history and not feel like they were rushing me. (P25)
Theme 3: Responsive care. Participants described how the team-based model created an approachable system where they felt comfortable reaching out with questions or concerns. They valued knowing multiple providers shared responsibility for their care. Rather than waiting for their next appointment, participants perceived they could contact the clinic between visits; they also appreciated both the flexibility of the system and that the team member best suited to address their specific concern could respond. This approach allowed for timely responses to nonurgent questions, which participants valued for ongoing support and guidance:
I’ve had phone calls with [the pharmacists] outside of my visits… So I left a message for the two pharmacists there. Just kind of a quick… “Hey, this is my dilemma or my question, and I would appreciate if you could weigh in”…. And they gave me a call back. Like it’s not a call back necessarily in two hours, but within two days I get that phone call back. (P14)
The perceived ability to reach out between scheduled appointments provided reassurance and continuity of care:
They’re always available for questions. I can pop them an email anytime and they are available. They get right back to me, or they give me a call and we discuss what’s going on. (P25)
Theme 4: Timely care. Participants perceived that having multiple healthcare professionals working together facilitated quicker appointment times, particularly for their initial consultation. This was partly attributed to IHPs taking on responsibilities to assess and triage cases based on urgency:
They considered me in their triaging process to be a more urgent case. I was in with [the doctor] within two weeks. That’s how it started out at that clinic. (P25)
The flexibility of the team-based system allowed for adjustments to accommodate urgent needs:
Got into CArE…; had a meeting on—for about an hour on the triage. And then she was able to move some things around and get me in the next day. (P7)
Participants noted the speed of the initial assessment compared to their expectations and contrasted this with wait times experienced in more traditional rheumatology practices:
Like I say, just shocking how fast we’ve been able to tackle this… within like a week or so I was able to get in there. (P7)
Theme 5: Personalized care through efficient interdisciplinary integrated expertise. Participants appreciated how team-based care facilitated individualized treatment plans through the coordinated application of specialized expertise. The team approach enabled treatment decisions that were specifically tailored to each patient’s unique circumstances, preferences, and needs, drawing on the input from healthcare professionals across disciplines as needed. The collaborative decision-making process among diverse team members allowed for consideration of multiple aspects of the patient’s condition simultaneously, creating care plans that addressed not only the medical management of their disease but also its functional, psychological, and practical effects on their daily lives. Participants perceived the comprehensive care plan exceeded what a physician alone could provide:
Doctors are great but they are limited. They are limited in their time. They are limited in their scope of practice. They are limited in their knowledge. A doctor can’t be an expert on everything and so many diseases have so many different aspects to them. It’s not just about bloodwork and medication. (P25)
Participants valued the integration of different professional perspectives within 1 clinical setting. This collaboration enabled comprehensive care delivery within 1 clinic rather than traveling to multiple different clinics to see different providers and stitch together a plan on their own:
I think having all the helpful groups represented in one office instead of having to go to a physiotherapist somewhere else and instead of having to go to a pharmacist at the drug store… To have it all under one roof and see them all in one appointment to me that’s like a huge saving of your time, but also of your energy. (P24)
Everybody’s working together for the right purpose. Get this person back up and running. It’s like a pit stop. You don’t want to take all day in that pit stop; you want to get that thing in and out and back on the road again so it can win the race. (P18)
This emphasis on coordinated efficiency was echoed by other participants, with one describing the integrated model as a “one-stop shop”:
It’s like a one-stop shop where everybody is under the same roof, everybody knows they’re on the same page. They know exactly what the treatment plan is. They know exactly what the goals are and that’s I think vital to the success of the clinic. (P28)
DISCUSSION
This study explored perspectives of patients receiving rheumatology care within an interdisciplinary team-based model, identifying 5 key themes: educational empowerment, unhurried thoroughness, responsive care, timely care, and personalized care through efficient interdisciplinary integrated expertise. These findings illuminate how patients perceive interdisciplinary teams to deliver comprehensive, personalized care in a more efficient and patient-centered manner than traditional models. These results confirm that interdisciplinary care is valued by patients and, alongside literature demonstrating improved patient outcomes,12-15,18 support the broader implementation of interdisciplinary team–based models in rheumatology.
We found that patients experienced interdisciplinary team–based rheumatology care as providing comprehensive educational support, unhurried assessments, responsive communication, timely access, and personalized care coordination. Our results build upon and extend existing rheumatology literature. Bryant et al found that rheumatology patients valued comprehensive care and communication.18 Our findings support this and demonstrate how team-based models can effectively deliver these desired elements. The educational empowerment and thorough assessments our participants described align with patients’ documented needs for better understanding and more complete care.23 Although previous studies documented clinical benefits, such as pain reduction, improved self-management14 and patient satisfaction with specific team collaborations,12,13 our findings reveal the underlying patient experience mechanisms driving these outcomes. Patients described experiencing improvements through personalized care that simultaneously addresses medical, functional, and practical needs, suggesting that improved clinical outcomes may stem from the comprehensive, coordinated approach to care.
Our findings indicate that patients perceive team-based models as effectively addressing current challenges in rheumatology care. Participants particularly appreciated the “one-stop shop” approach, where multiple services are coordinated within a single clinic, reducing the logistical burden and potential for fragmented care. By bringing essential care elements together in a patient-centered way, care coordination and continuity improves. These findings align with research in other chronic disease settings, highlighting patient appreciation for accessible, coordinated, convenient, and comprehensive care.19,32-34
Our findings demonstrate that patients value the core elements of integrated care—specifically care coordination, person-centered approaches, and collaborative decision making—which aligns with established frameworks like the International Foundation for Integrated Care’s Nine Pillars, particularly the emphasis on collaborative service delivery and patient partnership in care decisions.35 Patients did not just accept team-based care—they actively valued how different professionals contributed specialized expertise that created more complete care experiences than traditional single-provider models. The educational empowerment theme highlights how integrated care enhances patient activation and self-management support in chronic disease care.36 Patients described how team members’ distributed expertise helped them navigate the complex learning curve necessary for effective self-management, illustrating that coordinated care meets comprehensive needs better than fragmented care.
The collaborative approach aligns with research demonstrating that team-based rheumatology care improves clinical outcomes23 and patient satisfaction.12,13 Our findings reveal the patient-experience mechanisms underlying these benefits: personalized care enhances medical, functional, and practical needs simultaneously, suggesting that the clinical outcomes reported in previous studies may stem from the comprehensive, coordinated approach that patients value.
Although team-based care shows clear benefits, questions remain about the replicability of this model in other settings and patient populations. Variations in team composition, expertise, care processes, staffing, culture, and training may yield different outcomes and experiences. Understanding how team configurations and organizational environments influence care quality and consistency is essential for broader implementation. Further, certain patient populations may benefit more than others, highlighting the need for flexible program design and clear care coordination pathways that accommodate diverse patient preferences while maintaining the benefits of interdisciplinary collaboration.
This study has several strengths. The qualitative approach enabled deep exploration of patient experiences, capturing nuanced perspectives that quantitative measures might miss. Our sample included individuals with diverse rheumatic conditions and varying lengths of experience, providing breadth and longitudinal insights into team-based care. Our multidisciplinary research team with patient partners ensured rigorous and patient-centered analysis. Limitations include secondary analysis constraints (precluding interview guide modifications), single-site evaluation (limiting generalizability to other teams), predominantly White sample (reducing transferability to other groups), and potential selection bias.
In conclusion, this study identified 5 key themes reflecting participants’ perspectives with interdisciplinary team-based rheumatology care: educational empowerment, unhurried thoroughness, responsive care, timely care, and personalized treatment. The results strongly support the value of interdisciplinary team–based approaches from the patient perspective, demonstrating how such models can address key challenges in rheumatology care delivery, including access, education, coordination, and personalization of care. These insights support broader implementation for healthcare systems seeking to strengthen rheumatology care. Future research should seek to understand how team-based rheumatology care can be more widely implemented to improve patient and healthcare system outcomes.
ACKNOWLEDGMENT
We acknowledge the CArE Team30 for support in helping to facilitate patient recruitment while maintaining independence during the conduct of the study. LKK is supported by an Arthritis Society Canada Stars Career Development Award (star-24-0095). JW is supported by the Holland Chair in Musculoskeletal Research at Sunnybrook/University of Toronto.
Footnotes
CONTRIBUTIONS
Conceptualization: GS, ZL, CL, DT, LO, CB, CH, JW, JCT, LKK. Funding acquisition: CL, CB, CH, JW, JCT, LKK. Data curation: GS, ZL, CL, DT, LO, LKK. Investigation: GS, ZL, CL, DT, LO, CB, CH, JW, JCT, LKK. Writing - original draft: GS, ZL, CL, DT, LO, LKK. Writing - review and editing: all authors. Supervision: LKK.
FUNDING
This study was supported by the Transforming Health with Integrated Care (THINC) initiative at the Canadian Institutes of Health Research (IT6-188079).
COMPETING INTERESTS
JCT is the Founder of the Centre of Arthritis Research Excellence (CArE) but was not involved in data collection or analysis. The remaining authors declare no conflicts of interest relevant to this article.
ETHICS AND PATIENT CONSENT
The study followed the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist for reporting qualitative research. This study was approved by the University of Toronto Health Sciences Research Ethics Board (REB# 45644).
- Accepted for publication November 5, 2025.
- Copyright © 2026 by the Journal of Rheumatology
This is an Open Access article, which permits use, distribution, and reproduction, without modification, provided the original article is correctly cited and is not used for commercial purposes.
